I wish I had the answer to your question---but what I do know is that I was diagnosed 5+ years ago when I had a noticable tremor in my left hand and forearm. Since then I have had to adapt many of the things that I do--mostly these changes were gradual and not really noticeable to others. This year though I feel that I have gone downhill quite q lot. My legs ache and are unsteady almost constantly and my muscles are very rigid causing back pain. every thing I do seems to require tremendous effort leaving me exhausted. For the first time I feel as though I cannot do the things that I have taken for granted in the past. I am sure that every one is different and so you may not experience the same. Hope this has been helpful to you and good luck....